Umar Musa U, Salihu Auwal S, Owolabi Shakirat D
Department of Psychiatry, Bayero University Kano, PMB 3011, Kano, Nigeria.
Department of Psychiatry, Aminu Kano Teaching Hospital, Kano, Nigeria.
Atten Defic Hyperact Disord. 2017 Sep;9(3):189-198. doi: 10.1007/s12402-017-0218-9. Epub 2017 Jan 17.
Substance use disorder (SUD) is associated with ADHD. ADHD increases the severity of SUD and has negative influence on the prognosis of the disorder. The aim of the study was to determine the prevalence and correlates of ADHD in individuals with SUD. During 2013-2015, a cross-sectional descriptive study of 233 drug treatment-seeking individuals was assessed. Diagnosis of ADHD was done using DSM-IV criteria with the Diagnostic Interview for ADHD in Adults (DIVA 2.0), while Semi-structured Assessment for Drug Dependence and Alcoholism (SSADDA 6.1) and Adult ADHD Quality of Life (AAQoL) were used for diagnosis of substance use disorder and assessment of QoL, respectively. Multivariable logistic regression was used to determine factors that were associated with ADHD. The prevalence of ADHD in SUD patients was 21.5%, with the combined subtype being the most prevalent. SUD patient with ADHD had more history of severe dependence on cigarette, depression, suicidal ideation, aggression, dependence on benzodiazepine and heroin, number of relapses, poor QoL and number of hospitalization. After logistic regression, only the number of relapses (p = 0.004), history of aggression (<0.001) and poor QoL differentiated between SUD patients with ADHD from those with no diagnosis of ADHD. The prevalence of ADHD in SUD individuals is high and may be associated with a more severe phenotypic expression of SUD.
物质使用障碍（SUD）与注意力缺陷多动障碍（ADHD）相关。ADHD会加重SUD的严重程度，并对该疾病的预后产生负面影响。本研究的目的是确定患有SUD的个体中ADHD的患病率及其相关因素。在2013年至2015年期间，对233名寻求药物治疗的个体进行了一项横断面描述性研究。使用成人ADHD诊断访谈（DIVA 2.0）依据《精神疾病诊断与统计手册》第四版（DSM-IV）标准对ADHD进行诊断，同时分别使用药物依赖和酒精中毒半结构化评估（SSADDA 6.1）和成人ADHD生活质量量表（AAQoL）对物质使用障碍进行诊断和生活质量评估。采用多变量逻辑回归来确定与ADHD相关的因素。SUD患者中ADHD的患病率为21.5%，其中混合型最为常见。患有ADHD的SUD患者有更多严重依赖香烟、抑郁、自杀意念、攻击行为、依赖苯二氮䓬和海洛因的病史，复发次数更多，生活质量较差，住院次数也更多。经过逻辑回归分析，只有复发次数（p = 0.004）、攻击行为史（<0.001）和生活质量差能够区分患有ADHD的SUD患者和未诊断出ADHD的SUD患者。SUD个体中ADHD的患病率较高，可能与SUD更严重的表型表达有关。
